Drugs of Abuse Flashcards by Christina Provenza

addiction

overwhelming compulsion
criminal activity to obtain
extreme dependence (psychological or physical)

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part of the brain involved in addiction

nucleus accumbens

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drugs of abuse

opioids
CNS depressants
psychostimulants
nicotine
hallucinogens
marijuana
phencyclidine
volatile intoxicants

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examples of opioids

heroin
methadone
morphine
codeine

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opioid MOA

mesolimbic DA system
inhibits GABA release which leads to increased activation of the ventral segmental area neurons and increased dopamine release

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effects of opioids

euphoria
sleepiness
anxiety release
analgesia
depression of cough reflex

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methadone

opioid against
slowly acting
less euphoria and withdrawal symptoms
used for maintenance therapy
can be tapered off slowly or on for life
only at clinics

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buprenorphine

opioid agoinst/antagoinst
maintenance treatment
less respiratory depression and withdrawal than methadone
available at pharmacies

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naltrexone

opioid antagonist

used for dependence, rapid detox, or maintenance

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most severe withdrawal symptoms

opioids

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opioid withdrawal symptoms

not life threatening
anxious
mydriasis
increased pulse
piloerection
secretion
muscle aches
NVD
dehydration

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examples of sedative-hypnotics (CNS depressants)

benzodiazepines

barbiturates

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alprazolam

benzodiazepine

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diazepam

benzo

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lorazepam

benzo

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flunitrazepam

benzo

roofies

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effects of sedative hypnotics

euphoria

stimulation

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treatment of benzo overdose

taper off slowly- can give a longer acting benzo
tremor- propranolol/clonidine
anxiety- buspirone

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benzo withdrawal symptoms

tremor
insomnia
anxiety
abdominal cramps
orthostatic hypotension
hyperreflexia
weakness
illusions and hallucinations
seizures
delirium

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examples of stimulants

cocaine
crack
amphetamines
methylphenidate
MDA
MDMA
caffeine
theophylline
nicotine

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MDMA

ecstasy

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crack vs cocaine

crack- smoke

cocaine- IV

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methylxanthines

caffeine

theophylline

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MOA cocaine

inhibits DA reuptake*

also inhibits NE and 5HT reuptake

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effects of cocaine

``` euphoria rush delusions hallucination increased HR/BP ```

overdose of cocaine

``` tachycardia HTN brain hemorrhage anxiety paranoia seizures unpredictable behavior ```

the runs

associated with cocaine | alternate cravings and drug taking which leads to crash

the blues

associated with cocaine fatigue depression hyperphagia

treatment of cocaine dependence

``` can only treat symptoms beta blockers for autonomic activity nitroglycerine- angina CCB- HTN ice bath- fever antidepressants- depression haloperidol- psychosis alprazolam- panic attacks ```

cocaine withdrawal symptoms

``` depression sleepiness craving bradycardia not life threatening decreases over weeks ```

amphetamines MOA

release of endogenous amines- DA NE | inhibit transporter

effects of amphetamines

euphoria hallucinations anorexia fever

amphetamine overdose

``` tachycardia arrhythmia NVD delirium psychosis stroke seizure muscle rigidity rhabdomyolysis ```

effects of nicotine

increase E and NE from adrenal gland increases sympathetic and parasympathetic activity increases ACTH from pituitary

positive effects of nicotine

``` anxiolysis cognitive enhancement cerebrovasodilation neuroprotection analgesia anti-psychotic ```

negative effects of nicotine

``` GI distress hypothermia emesis HTN seizures respiratory distress ```

acute nicotine intoxification

respiratory arrest from blocking respiratory centers and NMJ for breathign

chronic effects of nicotine

heart disease lung disease/cancer low birth weight asthma in kids

withdrawal symptoms of nicotine

nervousness | sleep disturbances

methods of nicotine cessation

nicotine gum patches nasal spray varenicline

varenicline

partial nACh agoinst- blocks receptors to prevent withdrawal and prevents nicotine from binding

hallucinogen examples

LSD mescaline LSM psilocybin

acute effects of low dose hallucinogens

``` thought distortion visual hallucinations synthesis dizziness nausea blurred vision anxiety tension dilated pupils increased HR, BP, temp, reflexes ```

acute effects of high doses of hallucinogens

panic | paranoia

MOA of hallucinogens

5HT2a receptor* | mimics 5HT, DA, Ach

active ingredient in marijuana

cannabinoid (THC) | dronabinol- synthetic THC

acute effects of marijuana

``` rapid onset euphoria relaxation altered passage of time memory impairment ```

high doses of marijuana effects

visual hallucinations | psychosis

medical uses of marijuana

increase appetite decrease nausea decrease IOP relieve chronic pain

chronic effects of marijuana

short term memory issues lung disease decreased testosterone

MOA of marijuana

inhibit adenylate cyclase inhibit Ca channel serotonin and Ach release limbic system inhibition

psychological dependence of marijuana

anxiety irritable insomnia nausea

phencyclidine

PCP

effects of low dose PCP

dreamy, altered perception impaired judgement partial amnesia

effects moderate dose PCP

``` inebriation dissociation decreased pain sensitivity ataxia abnormal body sensations mood swings ```

high dose effects PCP

``` hallucinations catatonia delirium amnesia HTN crisis ```

MOA of PCP

NMDA antagonist | block DA reuptake

acute effects of inhalants

euphoria numbness tachycardia hyptension

long term effects of inhalants

loss of finger dexterity | severe neurological deficiencies

effects of industrial solvents

euphoria disorientation time perception changes

rank order of addiction risk

cocaine > opioids = nicotine > marijuana > PCP = hallucinogens

naltrexone

opioid and alcohol dependency

methadone

opioid dependency

buprenorphine

opioid dependency

clonidine

opioid withdrawal

disulfiram

alcohol dependency

acamprosate

alcohol craving